DEAR DR. DONOHUE: I am a 15-year-old girl with a big problem -- my weight. I have been making myself throw up after I eat, and I can eat a lot. If I don't do this, I will look like a blimp. A friend tells me I am sick and will make myself sicker by doing this. Is it dangerous? Why? -- R.K.
ANSWER: The condition is called bulimia, a Greek word that means "ox hunger." It's a serious nutritional and psychological disorder.
It is nearly impossible for you to conquer this by yourself. You need to enlist your family doctor for a referral to a specialist in eating disorders.
The signs of bulimia include eating large amounts of food in two or fewer hours at least twice a week for three or more months.
Frightened that the eating binge will make her ("her" because more females than males have it) fat, the bulimic, in panic, gets rid of the calorie load by inducing vomiting, taking laxatives or exercising to the extreme.
The self-induced vomiting upsets the body's acid-base balance, and that leads to serious troubles. Vomiting irritates the esophagus and the throat. Those digestive juices can erode teeth, and this is only scratching the surface of the dangerous consequences for which bulimia is responsible.
A professional often employs a technique called cognitive-behavior therapy to rescue someone from the clutches of bulimia. This therapy shows bulimics how their self-image is distorted and helps them regain a true perception of their body. Often medicines such as Prozac are an important aspect of treatment.
Bulimia is often called bulimia nervosa, identifying it with the other common eating disorder, anorexia nervosa.
DEAR DR. DONOHUE: My blood pressure is a yo-yo. Some days it is right on target. Other days it is high.
Do I need treatment? I get my pressure checked at work by a nurse. -- W.S.
ANSWER: A yo-yo blood pressure is called labile hypertension. It presents a dilemma for patient and doctor. No doctor wants to prescribe medicines when they are not needed. No doctor wants patients to suffer the consequences of high blood pressure -- heart attack, stroke and kidney disease -- if left untreated.
You are an ideal person for ambulatory blood pressure monitoring. You wear a blood pressure cuff on your arm, and the cuff is attached to a small gadget that records blood pressure every 15 to 30 minutes for 24 hours. With such a record, the doctor is better able to make decisions about treatment.
If a number of readings are high, then the pendulum swings toward treatment. If labile hypertension has produced artery changes, heart enlargement or kidney impairment, then treatment is mandatory.
Have you tried nonmedicine blood pressure treatments? Do. Lose weight if you are carrying too many pounds. Cut back on salt and salty foods. Increase calcium- and potassium-rich foods. Calcium and potassium can lower blood pressure. Calcium-rich foods are dairy products -- low-fat dairy products. Potassium-rich foods include potatoes, oranges, orange juice, bananas, cantaloupe, tomatoes, green beans, peas and many green, leafy vegetables.
Start an exercise program. Exercise lowers blood pressure. Even a modest daily walk can bring down blood pressure numbers.
You'd be wise to discuss your blood pressure with a family doctor.
DEAR DR. DONOHUE: I have lost a lot of weight. I am proud of myself. I am left with stretch marks. Do they ever go away? Can I put something on them? -- H.W.
ANSWER: Stretch marks are scars that form when skin is stretched beyond its elastic limits. All scars are most noticeable early on because they are red. The color fades as time passes, and the marks are less obvious.
Consult a dermatologist. Retin-A, an acne medicine, is sometimes prescribed for stretch marks.
Laser treatments are another possibility.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.